Category Archives: counseling science

February 8, 2011 · 11:26 am

Godly depression?


Last night my psychopathology class focused on the topic of depression. We covered the usual stuff: various experiences and features of depression and bi-polar disorder, potential medical causes, common medical and psychological treatments, etc.

Depression, as you most likely know, comes in all sizes and shapes and is multifactorial in etiology. Depression involves the body, the mind and spirit, and the environment. Thus, treatments should also cover the gamut, focusing on thoughts, faith, body, and environment. I ended the class pointing briefly to the fact that the English Puritan treatment of depression covered pretty much the same. They encouraged their parishioners to treat their despair and melancholy with these ideas,

  1. Seek the benefit of “Physick” or medical interventions
  2. Accept the comfort of Scriptures and in community with friends (and they also counseled others to avoid over-use of exhortation)
  3. Be mindful of God’s present and past mercies
  4. Utilize the sacraments and other spiritual disciplines
  5. Avoid too much time in introspection, but
  6. Examine oneself to see if there are also hidden issues to be dealt with

Notice the “heart surgery,” as one of my students put it in her paper, doesn’t happen til much work has been done to stabilize and comfort the despairing individual.

KEY QUESTION: Is there such thing as Godly depression?

If so, what would it look like? This question comes out of the view that depression and accompanying hopelessness reveals, to some degree, that a person is failing to trust the Lord.

Or does it? Is it possible to be depressed and spiritually mature? I believe so. So, what signs might you look for to determine that the person in front of you was experiencing a Godly depression? Was St. Paul despairing to the point of death but wholly trusting the Lord at the same time? (2 Cor 1:8f)

25 Comments

Filed under christian counseling, christian psychology, Christianity, counseling, counseling science, Depression, Doctrine/Theology

Tagged as , ,

February 5, 2011 · 12:12 pm

Single session therapy?


Anybody ever found just one session of counseling productive (meaning you only went once but it was extremely helpful)?

Counseling takes time…usually. You want to get to know your client, hear their history, learn how they think and feel, what they have already tried, and walk with them into some new ways of thinking or responding to their life situations. This kind of work takes time, a lot of time in some cases. And the solutions take even more time.

But I suspect there are some folk who could benefit from just 1 hour of troubleshooting. If you have had one of those experiences, what happened? What was helpful?

8 Comments

Filed under counseling, counseling science, counseling skills, Uncategorized

Tagged as , ,

January 18, 2011 · 7:48 pm

Adult Asperger’s?


DSM-IV-TR, the current DSM edition

Image via Wikipedia

In last night’s Psychopathology class I was discussing the significant changes throughout the history and editions of the Diagnostic & Statistical Manual (I-VI), especially in regard to the growth of mental health diagnoses. That led us to talk about a couple of diagnoses, once added, that have become “popular.” By popular I don’t mean en vogue or fun or the like. What I mean is that there has been a significant increase in the usage of that diagnosis.

What diagnosis? Asperger’s Syndrome.

Why? Some feel it is because the diagnosis is known and now those who went undiagnosed now are more likely to receive a correct diagnosis. Others feel that therapists are over diagnosing–lumping in every kid who has any hint of a social quirk.

It will be interesting to see what happens to the numbers being diagnosed when DSM5 comes out (2013?) and Asperger’s is subsumed into a generic Autistic Spectrum Disorder. I’d be willing to bet that fewer people will get the diagnosis because of stigma alone.

Whether over or under used, there are adults who meet criteria for this diagnosis and who might be helped (along with their spouses) if they had some hooks to use to understand what was happening in their relationships. If you are involved in counseling folks who meet criteria for this diagnosis…or think you might, check out the this website.

Click the link “tests” and check out a couple of the free adult forms you might use in the diagnostic process. They may not be quite as robust in their statistical properties, but they do give you a good way to narrow the conversation with your clients.

6 Comments

Filed under counseling, counseling science, Psychology

Tagged as , ,

January 5, 2011 · 5:06 am

Additional information on the March 2011 sex trafficking and abuse conference at Biblical Seminary


I’ve mentioned the conference before here on this site. But here is additional information for those considering the conference in order to acquire either graduate academic or continuing education credit.

NOTE:

  • Conference dates: March 17-19
  • The conference is free for all attendees, only those who want CEs or grad credit will have to pay a fee
  • A PDF of the information below is available here: Please pass on to anyone who might be interested.

Continuing Education at Biblical Seminary

March 17-19, 2011

The Biblical Call: A Christian Response to Human Trafficking and Sexual Abuse[i]

Mental health professionals and clergy interested in attending this seminar may be able to acquire 10 contact hours of continuing education by attending this conference. Biblical Seminary is an accredited graduate institution and thus is qualified as a pre-approved provider of continuing education in the form of graduate coursework by Pennsylvania’s State Board of Social Workers, Marriage and Family Therapists, and Professional Counselors (§47-49.36) and Pennsylvania’s State Board Of Psychology (§41.59). (Attendees who wish to receive academic credit should follow directions in the footnote below.)

While Biblical Seminary provides verification of attendance and a transcript showing completion of the CE course, attendees are responsible to verify acceptance of these hours by their particular licensing boards prior to registering and paying for CEU credits.

The following information may be used to apply for approval to your licensing body.

Speakers:

Diane Langberg, PhD; Bethany Hoang, MDiv; Pearl Kim, JD; Robert Morrison, MBA; Philip G. Monroe, PsyD

Seminar Overview:

This conference continues the “Conversations on Christianity and Culture” series focusing on sexual violence and injustices in a variety of contexts: domestic and international settings and sexual abuse in Christian communities. Attendees will explore these issues from biblical, psychological, legal, and sociological perspectives. The conference will conclude with a focus on practical intervention and prevention strategies.

COST:

The conference is free for all attendees. Register here. Those who wish to receive CE credits will be charged $20.00 per CE unit (0-9 credits) or $180.00 for all 10 CE units. Attendees will be billed following the conference and certificate of attendance will be held until payment is received.

Educational Objectives:

  1. Become familiar with the psychological and sociological data regarding domestic and international trafficking phenomena and also sexual violence within Christian settings
  2. Describe common community and individual consequences resulting from these sexual traumas
  3. Consider biblical and theological factors relating to sexual violence
  4. Identify effective and practical interventions as well as preventative actions to treat and stop sexual slavery and sexual violence

Tentative Schedule:

Thursday, March 17

Speaker Title Time length
B. Hoang Biblical Call: Response to Violence (obj. 3) 1:15
D. Langberg Biblical Call: Global Violence against Women and Children (obj. 1-3) 1:15

Friday, March 18

Speaker Title Time length
B. Hoang International Human Trafficking (obj. 1) 1:15
D. Langberg Domestic Human Trafficking (obj. 1) 1:15
Breakout Sessions (choose two as each session is repeated; total length: 2:30)
B. Hoang Follow up from morning session (obj. 3) 1:15
D. Langberg Follow up from morning session (obj. 1-3) 1:15
P. Kim Spiritual Warfare and Criminal Prosecution (obj. 3) 1:15
R. Morrison Mobilizing all Christians in Effective Action Against Human Trafficking (obj. 4) 1:15

Saturday March 19

Speaker Title Time length
D. Langberg Sexual Abuse in Christian Organizations (obj. 1-4) 1:00
Panel (all speakers) Panel Discussion (obj. 1-4) 1:30

[i] This course is also available for one (1) academic credit. Credit students will be required to complete additional readings and coursework after the seminar. Those interested should view the course syllabus on our school’s website and complete a brief, online non-degree application. Cost for a one credit course is $447.

Leave a comment

Filed under Abuse, Biblical Seminary, christian counseling, christian psychology, counseling, counseling science, counseling skills, Post-Traumatic Stress Disorder

Tagged as , , , , ,

November 22, 2010 · 10:10 am

Psychological mystery recommendation: White Lies


Just finished Anna Salter’s novel, White Lies. The book was published 10 years ago, so you may have already come across this great read. If not, Dr. Salter is a forensic psychologist with expertise in the area of sex offending. I highly recommend the book if you want to see how a psychologist goes about gathering data on a perpetrator so as to recommend treatment or predict future re-offending.

What I found most interesting was her use of sentence analysis (written and spoken) to highlight how we tend to deceive self and others. Lying comes in what we say and don’t say. At one point, the offender (a doctor) states that he started his residency at such-and-such a place but never mentions where he finishes it. She evaluates the sentence and tells the reader that the offender has told more of the truth than he planned. No one would say they started it somewhere unless they didn’t finish it there. Instead, you would say, “I did my residence at…”

Her work reminds me of some training I got from Eric Ostrov as an intern at a juvenile jail facility. Dr. Ostrov told us that people generally want to confess their sins–or at least a more acceptable version of them. They make themselves passive in an event, they confess a sin they wished they committed (e.g., crossing sexual lines with a client who seduced them) rather than the sin they did commit (inviting and manipulating a client into a sexual situation).

Long ago I had aspirations of becoming a forensic psychologist. In fact, I did some training and practice in my pre and post doc and had a job offer lined up. I ended up choosing to come to Biblical Seminary. While I don’t regret that choice, the work of exploring self and other deception still interests me.

Anybody out there read her other two novels: Fault Lines or Shiny Water?

Leave a comment

Filed under Abuse, counseling and the law, counseling science, Good Books, self-deception

Tagged as , , , ,

November 19, 2010 · 6:46 pm

International Suffering and Trauma Treatment


Am working with a student on building a future course for students, licensed mental health providers, NGO workers to train them on the matters of trauma treatment in international settings with the course goal to take these trainees to a location where they train local trainers to use lay trauma healing measures.  I am imagining a course that is primarily on-line (using a course website, discussion board, webcasts, etc.) with some face-to-face time just prior to having the international experience. The course would enable licensed therapists to receive continuing education credits with the ultimate goal that those who complete this experience would be then prepared to replicate it in other parts of the world. Topics would include:

  1. Overview of trauma symptoms and the things that cause them (genocide, war, trafficking, domestic abuse, rape, natural disasters, etc.)
  2. Overview of local culture and customs re: health, strength, and medical intervention to ensure culture consistency and avoiding colonialistic approaches.
  3. Introduction to training lay trainers
  4. Secondary trauma and compassion fatigue issues

I have two reasons for a course like this: 1. trauma is everywhere, and 2. interventions need to be sustainable (not relying on western therapists to keep doing the direct service) and maintained by local individuals.

So, here’s my question: If you had an opportunity to shape a course like this, what would you want to see as part of the course? What would you want to avoid?

6 Comments

Filed under Abuse, counseling, counseling science, Post-Traumatic Stress Disorder

Tagged as ,

November 15, 2010 · 9:53 am

Can you change your nightmares?


Blogging has been much harder this fall with a busy teaching and traveling schedule. I’ve been doing a lot of reading and thinking about best practices to deal with trauma in international settings–specifically in the Great Lakes region of Africa. Diane Langberg and I have been consulting with a Christian organization to help develop those practices with a local, sustainable mindset.

One of the recent items I read had to do with attempts to address repetitive “posttraumatic nightmares.” Bret Moore and Barry Krakow published, “Imagery Rehearsal Therapy: An Emerging Treatment for Posttraumatic Nightmares in Veterans” in the September 2010 issue of Psychological Trauma: Theory, Research, Practice, and Policy (v. 2, 232-238).

Imagery Rehearsal Therapy (IRT) attempts to alter nightmares by changing the storyline of the nightmare. The authors view nightmares as learned behavior such as insomnia. The CBT style treatment entails

  1. education about the relationship between nightmares and insomnia.
  2. education about cognitive restructuring via imagery
  3. client selects a particularly disturbing nightmare (maybe not the most disturbing one first)
  4. Client then instructed to “change the nightmare anyway you wish” (notice they are not asked to make it positive or even less distressing)
  5. Client then rehearses (over sessions) the new dream through imagery techniques

Previous controlled studies indicate a reduction in nightmare frequency and intensity. This particular summary article reports that the evidence is there that veterans find it helpful even at 12 months post treatment with 4 sessions.

A couple of things to note. There may be some effect of desensitization from rehearsal of the initial dream (exposure therapy) though the exposure is brief. Also, the client does not spend time rehearsing the actual traumatic events in this therapy–only the nightmares.

Some thoughts:

  1. This treatment makes sense. Ever have a dream that seems to go on and on, or one that you go back to upon waking up in the middle of the night. Often we may find ourselves trying to make the dream turn out okay. This treatment uses our fully awake brains to rehearse something we want to think about.
  2. If nightmares are the result of a collection of anxieties then it stands to reason that repeating new thoughts and images will begin to make associations in the brain that might compete with the anxieties.
  3. Christian living emphasizes re-telling the truth to ourselves. Consider how OT authors remind readers of the Exodus or Paul reminds the Ephesian readers of their prior state (chapters 1-3). What we rehearse does have an impact on our brains.
  4. Finally, some of our nightmares seem written in indelible ink. Do you still have test anxiety nightmares 20 years after your last class? I do. But I feel differently about them now than I might have back when I was still worried about school. It may be that we begin to feel differently about the nightmares. The less we are bothered by them the more infrequent they will be.

5 Comments

Filed under counseling, counseling science, counseling skills, Psychology

Tagged as , , , ,

November 1, 2010 · 10:18 am

Coming to Peace with Psychology 6


After a long hiatus I return to my summary/review of Everett Worthington’s Coming to Peace with Psychology (IVP, 2010). If you are new here just search his last name in the search bar on my blog and you can quickly catch up.

Chapter 10 is the second chapter in the last section of the book (“What Psychological Science has to Offer Theology”). This chapter covers the limitations of psychological science. Up to this point he has been lauding the value of psychological science as a marriage partner with theology. In fact, the purpose of the book is to argue for such a relationship over those who he sees as being overly critical of psychological science (due mostly, in his mind, to the anecdotal nature of psychological theory).

What does he point to as the limits of his science?

  • Despite amazing advances in psychological science, counseling hasn’t changed much (hmmm, does he consider this a limit of science or is this a complaint about practitioners?)
  • Psychological science must focus on general truths and so may not be as applicable to any one person
  • Scientists are not without bias (but then he goes on to say that given the review process, truth is a lot more likely than not)
  • Science can’t reveal the eternal (but it can reveal things of eternal value)
  • Inability to precisely predict behavior
  • No ultimate “proof” (but, probability is possible)
  • Scientist biases include “heuristics” (picking answers from an “available” list), confirmation biases, etc. which reveal our human self-serving nature.
  • Emotional experiences tend to make us more certain of our perceptions and beliefs.
  • human limitations on what we can remember, understand, perceive, do.

Notice from his list that he focuses on common human limits of knowing. This is a good start but insufficient. It treats science biases in an individualistic manner. I find this ironic given that I believe he has much awareness of family systems. In fact, systems add an additional bias–group think as example number one. Funny too that he gave very few illustrations from science of these various biases. For the most part, he illustrated them from everyday life or from theology. So, we are left with a chapter that admits to some general limits on how far psychological science can take us but no clear acknowledgment of systematic biases in the world of psychological science.

Now, let me be clear. I am not one who believes that psychological science is always biased all the time. And even when it is, there can be much to be learned from it. Nor do I believe that those within biblical studies or theology are unbiased either. But, I do think we need to recognize how specifically these biases send psychological science in some wrong directions.

Leave a comment

Filed under christian counseling, christian psychology, Christianity, counseling, counseling science, Psychology

Tagged as , ,

October 22, 2010 · 5:07 am

Normalizing Psychiatric Problems: Pro and Con


One of the hallmarks of the Biblical Counseling movement has been the clear articulation that psychiatric problems are not different in kind from any other set of problems. This assertion is made by some for a couple of reasons:

  1. To make sure everyone knows that the bible speaks to every kind of experience. if one draws lines between “regular” anxiety and pathological anxiety, those who meet the criteria for a DSM diagnosis might think that biblical material cannot speak to their situation–that they need to go elsewhere for help. God cares for and addresses every concern.
  2. To level the playing field between professionally trained counselors and biblical counselors. If the roots of human problems are common no matter the outer expression of them, then pastors and lay counselors can understand the issues (pride, suffering, fear, despair, etc.) and walk alongside anyone. One may not need special training to help another.
  3. To communicate to the healthy that they are not different from the more obviously unhealthy. The point is to reduce stigma and promote unity.

Consider the pros and cons of this viewpoint.

Pro:

  • Reduction of stigma and ghettoization
  • Increase normalization (“so, I’m not so different from others) and similarity with the rest of humanity
  • Increase the confidence and courage of leaders to address and dialogue about all forms of suffering

Con:

  • Decrease in interest in the specific experiences of suffering thus narrowing problems down to a simplistic cause (sin?)
  • Possible over-confidence of some leaders leading to a reduction of empathy and listening to the experiences of other; failure to consider body/mind issues not specifically elaborated on in the Bible.
  • Failure to recommend outside helpers with specific expertise and training; dismissal of the need to have professional counselors who may have greater practice with certain kinds of interventions\

When I teach my Psychopathology course I want my students to see just a bit of themselves in descriptions of people with thought disorders, addictions, eating disorders and the like. I want to normalize these kinds of problems so that students don’t think of clients with the problem as somehow different from their own experiences. While I may not binge, I may be able to empathize with those who do. However, I do not want them to think their brief binge as exactly the same as someone else’s experience. Otherwise, they might assume it would be easy to “just say no” to the binge.

When I teach my Physiology course, I want my student so to see the complexity of the brain and body and thus recognize the unique forms of suffering some go through. I want them to realize just how little we understand how much the body influences our experience of the world and of self. However, I do not want them to medicalize psychiatric problems. If they did that they might believe that counseling has little influence on psychiatric disorders. They might think that biblical reflections on anxiety and depression have no place in the healing of serious problems in living.

What is your experience regarding christian leaders handling of psychiatric problems? Do you see too little normalization? Too much? Do you see minimization of psychiatric suffering?

7 Comments

Filed under biblical counseling, christian counseling, christian psychology, Christianity, counseling, counseling science, Psychology

Tagged as , , , , ,

October 15, 2010 · 1:02 pm

Save the Date! March 17-19 2011


Dr. Diane Langberg and Bethany Hoang (IJM) will be doing our next Conversations with Christianity and Culture seminar March 17-19, 2011 on the topic of sexual abuse in the christian community. They will also be speaking about sex and human trafficking.

This is a free conference at Biblical Seminary. I’ll post on-line registration information here when it is available but I’m tell you this now so you get it on your calendar.  You won’t want to miss their presentations.

We expect to offer CEUs for mental health providers for the conference (probably very nominal fee) and academic credit too (in the form of ind. study) for those wanting to do some further work on the topic.

3 Comments

Filed under Abuse, christian counseling, christian psychology, counseling, counseling science, counseling skills

Tagged as , , , ,